Types of Major Depression

Depression with Melancholic Features

This is another severe form of depression.

Sufferers of depression with melancholic features withdraw into a dense cocoon of misery that nothing can penetrate. Nothing seem to make them happy. Even the most joyful events in life seem empty and have no meaning to them.

The victims of this depression are frigid and have lost the capacity to experience pleasure.

Other symptoms include the disappearance of appetite, severe weight loss, and a terrible problem getting any sleep.

The victims feel that their body is almost as broken as their mind.

Some people become so impaired that they are unwilling or unable to dress, may stop washing or feeding themselves, may stop eating, and may wind up spending the entire day alone lying in bed ruminating in a frantic and agitated state. This can lead to a medical emergency with dehydration, malnutrition, exhaustion, and suicide risk.

Here is a typical scenario:

You wake up at 3 A.M. feeling absolutely rotten, desperate, and agitated. You turn on TV but can't watch, pick up a book but can't read, try soothing music but feel irritated by it. You return to bed-but toss, turn, and fret in the endless hours before dawn. As the sun rises, you begin pacing around the apartment but feel no relief or comfort and finally go back to bed. You feel worthless wasting time in bed but you are too washed out to get up.

Your mind is filled with self-criticism, ruminations, catastrophization, and worries.
As the day progresses, you feel a bit better. By late afternoon you are relieved enough to eat a light meal and get dressed. The evening is not fun, but it is not an agitated torture. By 3 A.M. the next morning, however, you are back in the lowest circle of hell.

Treatment

Psychotherapy is totally ineffective for this type of severe depression. The victim may view the psychotherapy as added burden and hence the condition can get worse. Antidepressant medication is usually the treatment of choice but electro convulsive therapy (ECT) may be necessary if rapid results are needed or if the medicine has not worked very well.